Trends in opioid prescriptions among children and adolescents in the United States: a nationally representative study from 1996 to 2012

Pain. 2016 May;157(5):1021-1027. doi: 10.1097/j.pain.0000000000000475.


Prescription opioid misuse is a major public health concern in the United States, yet little is known about national prescription patterns. We aimed to assess trends in opioid prescriptions made to children and adolescents, to their families, and to adults in the United States from 1996 to 2012. The sample was drawn from nationally representative data, the Medical Expenditure Panel Surveys. We used survey design methods to examine trends in prescription opioid use over time and a logistic regression analysis to examine predictors associated with opioid use. Findings indicated that from 1996 to 2012 opioid prescriptions to children and adolescents remained stable and low. In 1996, 2.68% of children received an opioid prescription, and in 2012, 2.91% received an opioid prescription. In contrast, opioid prescriptions to family members of children and adolescents and adults in general significantly increased during this period. The most common opioid prescriptions to children and adolescents in 2012 were codeine, hydrocodone, and oxycodone. Using multivariate logistic regression models, the white non-Hispanic race, older age, health insurance, and parent-reported fair to poor general health were associated with higher rates of opioid prescriptions in children and adolescents. Our main finding was that although the rates of opioid prescriptions have increased among adults in the United States, the rates have not changed among children and adolescents. Recent epidemiologic association studies have identified a strong link between increased opioid prescriptions and increased rates of opioid misuse and abuse in adults. Future studies should assess the association between adult opioid prescriptions and children or adolescent opioid misuse.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Analgesics, Opioid / adverse effects*
  • Child
  • Child, Preschool
  • Databases, Factual / statistics & numerical data
  • Female
  • Health Surveys / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Longitudinal Studies
  • Male
  • Opioid-Related Disorders / epidemiology*
  • Pain / drug therapy*
  • Pain / epidemiology
  • Prescription Drug Misuse / trends*
  • Prescriptions / standards*
  • Prescriptions / statistics & numerical data*
  • Retrospective Studies
  • Socioeconomic Factors
  • United States / epidemiology


  • Analgesics, Opioid